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Child Reluctant Of Having Food. Urine Test Showed Ketone, Prescribed ORS, Hd Fever And Given Basigyl. Suggest?

Posted on Sat, 14 Sep 2013

Question: Hi, I'm writing from India. My son is 3 yrs & 10 months young. For the last 15 days he was not taking any diet and was very reluctant to take any kind of food(we even tried fast food). We consulted our physician and under his advice he has undergone a urine test. Ketone (large) was found in his urine and our physician has prescribed him ORS and lots of fluids. After 7 days he started loose motion and was not all active. Then our physician prescribed him Basigyl-N and after administrated that he was recovering well. But from, yesterday, he was suffering from high fever(105 deg farenheit). This continues for 3-4 times. We are administrating Crocin. What could be the possible cause for his prologned illness?

Answered by Dr. E Venkata Ramana (2 hours later)

Brief Answer:
Not looking like a prolonges illness.

Detailed Answer:
Hi XXXXXXX XXXXX
Thank you for your query on Healthcare Magic.

For the last 15 days, the decreased appetite may be due to some underlying problem such as some infection.

But infection usually present with its symptoms such as cold, cough, fever, loose stools, vomitings, or burning micturition.

Presence of ketones in urine is indicative of precede starvation which is associated with not taking any diet.

Large quantity of ketones in urine is significant and underlying another problem such as diabetes to be ruled out by doing urine for sugar and blood sugar tests.

After 7 days, he suffered from an episode of gastroenteritis which was treated with antibiotic and the child recovered.

So it is not looking like a prolonged illness, but it seems he is having frequent episodes of some acute illnesses with normal health in between these episodes.

At present the child is having high grade fever since yesterday. It may be due to a virus as there are no other symptoms of some focus of infection.

Child needs physical examination to look for the focus of infection which is causing fever at present.

Continue to give Crocin in prescribed dose every 6th or 8th hourly depending on the presence of fever.

Do tepid sponging with lukewarm water to decrease temperature to normal.

And as he had febrile seizures in the past, I advise you to give lobazam in prescribed dose for 3 days during this febrile period.

Therefore consult the pediatrician for physical examination and management of this high grade fever.

Hope I have answered your query, if you have any clarification please let me know.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. E Venkata Ramana (43 minutes later)

Thank you Doctor for your reply. I've two questions.

Can the present high fever be associated with Typhoid as he has a vomiting tendency and confusion during this time?

Is it advisable to give him a cold water bath when the temperature reaches 105 deg of Fahrenheit?

Regards,
XXXXX

Answered by Dr. E Venkata Ramana (11 minutes later)

Brief Answer:
Not looks like Typhoid. No cold water bath.

Detailed Answer:
Hi XXXXXXX

Thank you for getting back.

Typhoid fever usually starts with low grade and gradually increase to high grade with a step ladder pattern.

And for 1 or 2 days duration fever, it is difficult to attribute the present illness to typhoid.

Vomiting tendency and confusion may be due to the presence of high grade fever as delirium and incoherent speech is commonly seen in children with high grade fevers.

Cold water bath is not advisable as the cold water bath will cause shivering which in turn lead to raise of body temperature by rebound phenomenon.

Instead do sponging with lukewarm water intermittently when there is high grade fever.

Hope I have answered your query, if you have any clarification please let me know.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. E Venkata Ramana (6 hours later)

Hello Dr. XXXXXXX

Thanks for your reply. I've just consulted with my physician and he has also ruled out Typhoid. He has given routine urine test to find out the reason for this high fever. Apart from Crocin( at a regular interval of 4-6 hr), he has prescribed Pan-D.

Regards,
XXXXX
Kolkata.

Answered by Dr. E Venkata Ramana (27 minutes later)

Brief Answer:
Continue crocin as advised, follow up with report

Detailed Answer:
Hi XXXXXXX

Thank you for getting back.

Continue the medication as per her pediatrician advise.

Pan-D comes in tablet and capsule form and it is difficult to give orally to the kid.
Ask the doctor for a suspension or dispersible tablet of an alternative drug so that it will be easier for the kid to take the medication.

Consult the doctor for follow up after getting urine test report.

Hope I have answered your query, if you have any clarification please let me know.

Regards.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar